<div> <p>n this episode, John Barry, historian and author of The Great Influenza: The Story of the Deadliest Pandemic in History, describes what happened with the 1918 Spanish flu pandemic, including where it likely originated, how and why it spread, and what may have accounted for the occurrence of three separate waves of the virus, each with different rates of infection and mortality. While the current coronavirus pandemic pales in comparison to the devastation of the Spanish flu, John highlights a number of parallels that can be drawn and lessons to be learned and applied going forward.</p> </div> <div> <p><span> We discuss:</span></p> </div> <div> <ul type="disc"> <li>What got John interested in the Spanish flu and led to him writing his book? [2:45];</li> <li>Historical account of the 1918 Spanish flu—origin, the first wave in the summer of 1918, the death rate, and how it compared to other pandemics [10:30];</li> <li>Evidence that second wave in the fall of 1918 was a mutation of the same virus, and the immunity immunity protection for those exposed to the first wave [18:00];</li> <li>What impact did World War I have on the spread and the propagation of a "second wave"? [21:45];</li> <li>How the government's response may have impacted the death toll [26:15];</li> <li>Pathology of the Spanish flu, symptoms, time course, transmissibility, mortality, and how it compares to COVID-19 [29:30];</li> <li>The deadly second wave—The story of Philadelphia and a government and media in cahoots to downplay the truth [35:50];</li> <li>What role did social distancing and prior exposure to the first wave play in the differing mortality rates city to city? [44:45];</li> <li>The importance of being truthful with the public—Is honesty the key to reducing fear and panic to bring a community together and combat the socially-isolating nature of pandemic? [46:15];</li> <li>Third wave of Spanish flu in the spring of 1919 [51:30];</li> <li>Global impact of Spanish flu, a high mortality in the younger population, and why India hit so much harder than other countries [55:15];</li> <li>What happened to the economy and the mental psyche of the public in the years following the pandemic? [59:20];</li> <li>Comparing the 2009 H1N1 virus to Spanish flu [1:02:10];</li> <li>Comparing SARS-CoV-2 to the Spanish flu [1:04:20];</li> <li>What are John's thoughts on how our government and leaders have handled the current pandemic? [1:08:00];</li> <li>Sweden's herd immunity approach, and understanding case mortality rate vs. infection mortality rate [1:10:40];</li> <li>What are some important lessons that we can apply going forward? [1:13:00];</li> <li>Does John think we will be better prepared for this in the future? [1:16:00]; and</li> <li>More</li> </ul> <p>Learn more: <a href="https://peterattiamd.com/">https://peterattiamd.com/</a><br /> <br /> Show notes page for this episode: <a href="https://peterattiamd.com/johnbarry">https://peterattiamd.com/johnbarry</a><br /> <br /> Subscribe to receive exclusive subscriber-only content: <a href="https://peterattiamd.com/subscribe/">https://peterattiamd.com/subscribe/</a><br /> <br /> Sign up to receive Peter's email newsletter: <a href="https://peterattiamd.com/newsletter/">https://peterattiamd.com/newsletter/</a><br /> <br /> Connect with Peter on <a href="http://Facebook.com/PeterAttiaMD"><u>Faceboo</u></a><u>k</u> | <a href="http://Twitter.com/PeterAttiaMD"><u>Twitter</u></a> | <a href="http://Instagram.com/PeterAttiaMD"><u>Instagram</u></a>.</p> </div>
Actionable Insights
1. Prioritize Truthful Communication in Crises
In public health crises, leaders must always tell the truth, even about uncertainties, because people can deal with reality, but unchecked imaginations fueled by misinformation lead to fear and societal breakdown.
Unified leadership from all sectors (government, business, medical) that communicates honestly can build community trust, prevent societal breakdown, and encourage collective action and mutual aid during a crisis.
3. Implement Early Social Distancing
Act early and aggressively with social distancing measures before a virus is widely disseminated in the community, as early action is crucial for effectiveness and a more benign outcome.
4. Build Public Health Infrastructure Proactively
Simultaneously build infrastructure for testing, contact tracing, and monitoring during a pandemic, rather than waiting for full testing capacity to develop, to get ahead of the virus.
5. Manage Public Expectations Realistically
Avoid making premature promises about specific end dates for a crisis, as unmet expectations can lead to reduced public compliance with necessary measures.
6. Communicate Uncertainty Transparently
When information is unknown during a crisis, explicitly state ‘we don’t know,’ explain why, and indicate when more information might be available to maintain credibility and manage expectations.
7. Avoid “Managing” the Truth
Do not attempt to ‘manage’ or manipulate the truth in communications, especially in public health, as this implies a lack of transparency and can erode trust.
8. Prepare for Future Emerging Pathogens
Recognize that as human development encroaches on wild areas, encounters with animal viruses will increase, necessitating serious investment in preparedness for emerging pathogens.
9. Embrace Intellectual Flexibility
Be willing to change your mind and thinking when new data emerges, rather than being wed to previously published or held beliefs, as this is a marker of a great thinker.
10. Prioritize Ethical Considerations in Interactions
When seeking help for tasks during a pandemic, consider the ethical implications of potentially exposing others to the virus, and opt for solutions that minimize risk, such as utilizing individuals who have recovered and likely have immunity.
11. Provide Supportive Care During Illness
In the absence of specific treatments for an illness, focus on supportive care such as keeping the patient hydrated and managing fever.
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